[Evaluation of the bleb morphology and the function of post filtration surgery using slit-lamp adapted optical coherence tomography and ultrasound biomicroscopy in glaucoma patients].
OBJECTIVE
To analyze the morphology and the function of subconjunctival filtering bleb in patients with glaucoma by slit-lamp adapted optical coherence tomography (SL-OCT) and ultrasound biomicroscopy (UBM).


METHODS
This retrospective study comprised 53 patients with glaucoma filtering surgery from 2002 to 2006. The post-operation blebs in 69 eyes of 53 patients were scanned by a SL-OCT or UBM and categorized by the reference of intrableb morphology. The function of post operation bleb was clarified using Singh's or Yamamoto's criterion. The results of SL-OCT scanning were compared with those of UBM.


RESULTS
This is a comparative study. The blebs were classified into four categories according to the images of filtering blebs' by SL-OCT or UBM. SL-OCT had 92.7% (38/41 eyes) sensitivity in predicting a functioning bleb by Singh's standard and 83.3% (20/24 eyes) specificity in predicting a nonfunctioning bleb, whereas, UBM had 66.7% (30/45 eyes) and 75.0% (18/24 eyes) by Yamamoto's criterion, respectively. The sensitivity in predicting a functioning bleb in the SL-OCT group was significantly (P = 0.003, Fisher exact test) different from the UBM group.


CONCLUSIONS
Our results suggest that SL-OCT scanning has more sensitivity and specificity than UBM in evaluating the function of filtering bleb. The close relationship between the function and the morphological classification provides an important objective basis in evaluating the outcome of antiglaucomatous surgery.
Wu
Qiang
Q
Department of Ophthalmology, Sixth People's Hospital Affiliated of Shanghai Jiaotong University, Shanghai 200233, China. wyan559@hotmail.com
Zhang
Yi
Y
Song
Bei-wen
BW
Lu
Bin
B
Guan
Jian-hua
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000000981:diagnostic imaging*; D005260:Female; D018463:Filtering Surgery; D005901:Glaucoma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D011184:Postoperative Period; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods; D014130:Trabeculectomy